Diagnostic accuracy of the urinalysis for urinary tract infection in infants

Alan R. Schroeder, Pearl W. Chang, Mark W. Shen, Eric A. Biondi, Tara L. Greenhow

Research output: Contribution to journalArticle

47 Scopus citations

Abstract

BACKGROUND: The 2011 American Academy of Pediatrics urinary tract infection (UTI) guideline suggests incorporation of a positive urinalysis (UA) into the definition of UTI. However, concerns linger over UA sensitivity in young infants. Infants with the same pathogenic organism in the blood and urine (bacteremic UTI) have true infections and represent a desirable population for examination of UA sensitivity. METHODS: We collected UA results on a cross-sectional sample of 276 infants 3 white blood cells/high-power field) was 96% (95% CI 92.5%-98.1%). Only 1 infant with bacteremic UTI (Group B Streptococcus) and a complete UA had an entirely negative UA. In infants with negative urine cultures, leukocyte esterase specificity was 93.9% (95% CI 87.9 - 97.5) and of pyuria was 91.3% (84.6%-95.6%). CONCLUSIONS: In young infants with bacteremic UTI, UA sensitivity is higher than previous reports in infants with UTI in general. This finding can be explained by spectrum bias or by inclusion of faulty gold standards (contaminants or asymptomatic bacteriuria) in previous studies.

Original languageEnglish (US)
Pages (from-to)965-971
Number of pages7
JournalPediatrics
Volume135
Issue number6
DOIs
StatePublished - Jun 1 2015

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Schroeder, A. R., Chang, P. W., Shen, M. W., Biondi, E. A., & Greenhow, T. L. (2015). Diagnostic accuracy of the urinalysis for urinary tract infection in infants . Pediatrics, 135(6), 965-971. https://doi.org/10.1542/peds.2015-0012